Follow the directions given by the pre-assessment clinic staff as they will develop a plan specifically for you.

If your GP or other health professional has started any new tablets, you must inform the pre-assessment clinic so that they can give you specific instructions about whether to take these medicines at the time of surgery.

In general terms:

What medicines should I stop or take prior to having surgery?

As a general rule you should take your usual morning medications with a sip of water on the morning of the operation unless instructed otherwise by the anaesthetic team.
It is important to cease some medicines prior to surgery, including blood-thinning drugs, also known as anti-platelet drugs (aspirin and clopidogrel), and anticoagulants such as warfarin. If a heart specialist has prescribed them, this will be reviewed in the clinic and a plan developed for your surgery.

The decision about ceasing medications should be made primarily by the anaesthetic team in the pre-assessment clinic. They will talk with your surgeon and heart team to coordinate your care.

It is vital that you do not stop taking these medications without specific instructions on when to stop and restart them. If your medical condition requires you to remain on blood thinners until surgery you may commence a shorter acting form of blood thinner and this process will be managed by the anaesthesia team. 

Diabetes medicines will also require a specific plan and this will be arranged for you with the anaesthesia team.

These include various types of insulin or medicines taken by mouth to lower your blood-sugar level including metformin (DiaforminR, DiabexR) and gliclizide (DiamicronR).

Your plan will vary depending on whether you have type 1 (insulin dependent) or type 2 diabetes (non insulin-dependent). 

The aim is to have good control of your blood sugar for surgery to help reduce infection and improve healing of tissues.

Can I take herbal and dietary supplements?

The use of herbal medicines is common. Herbal medicine is defined as a plant-derived product used for medicinal and health purposes; commonly used herbal supplements include echinacea, garlic, ginseng, ginkgo biloba, St John’s wort and valerian.

Herbal medicines can have a variety of effects on surgery and interact with anaesthetic drugs. Ginkgo, ginseng and garlic all impair blood clotting and promote excessive bleeding. Prolongation of action of anaesthesia drugs can occur with valerian and St John’s wort.

Herbal dietary supplements should be stopped two weeks prior to surgery.

Fish oil supplements are also popular as a dietary supplement. They have potential in reducing cholesterol and hence may reduce the risk of heart attack and stroke. They also have anti-inflammatory properties and may be used to treat arthritis. The Therapeutic Goods Administration says that omega 3, which is found in fish oil, has no effect on bleeding and can be continued before surgery.